Healthcare Provider Details

I. General information

NPI: 1720650351
Provider Name (Legal Business Name): URBAN WELLNESS ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2021
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25807 WESTHEIMER PKWY STE 302
KATY TX
77494-5342
US

IV. Provider business mailing address

25807 WESTHEIMER PKWY STE 302
KATY TX
77494-5342
US

V. Phone/Fax

Practice location:
  • Phone: 832-862-5950
  • Fax: 346-396-3590
Mailing address:
  • Phone: 832-862-5950
  • Fax: 346-396-3590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. BRITTNEY N WASHINGTON
Title or Position: OWNER
Credential: LPC-S
Phone: 832-862-5950